A capital food fight over diet guidelines

It's vegans versus Atkins. It's lobbies like sugar, milk, meat, and soft drinks vs. experts promoting whole grains, leafy greens, nuts, berries, and fiber.

Washington is redrawing the food pyramid - the meal-planning chart that virtually every American knows about but few try to follow. And this time, the effort has become an open food fight, thanks to rising concern about obesity - and the popularity of diets that amount to a full-scale assault on time-honored food groups.

The players include some of the most powerful interests in Washington: The $500 billion food processing industry, the super-sized fast-food restaurant lobby, and an army of medical researchers, academics, and think tanks. In public comments, ordinary Americans are sending in their own recommendations for the food pyramid.

With so many interests weighing in, don't expect Washington to find a miracle meal map. No "beltway diet" is on the way. What's clear is simply that the challenge of obesity and the search for balanced lives has top-level attention.

"The rising rates of obesity in this country represent a public health crisis," says Rep. Henry Waxman, ranking member of the House Subcommittee on Human Rights & Wellness, at a hearing this week. The issue promises to be even bigger in the 109th Congress, which is expected to take up soaring health costs and Medicare reform.

Along with the questions about what people should eat is another divisive one: "Who's responsible?"

With nearly 1 in 3 adults considered "obese" and nearly 2 in 3 "overweight," the Department of Health and Human Services this year upgraded obesity from a behavior to a disease. That could put new pressure on healthcare insurers to cover medical costs related to the problem. At the same time, Republicans are urging new legislation to protect the food industry, especially fast-food restaurants, from obesity-related lawsuits.

Lawmakers see a major toll on national health costs - more than $117 billion a year in 2000, about half paid for by Medicare and Medicaid tax dollars.

Better diets and more exercise, experts say, are part of the answer.

"We need to speed up our response just as we would during an emerging infectious disease outbreak," says Julie Gerberding, the director of the Centers for Disease Control and Prevention. In a talk Thursday at the National Institutes of Health, she urged increased collaboration among government agencies, industry, and other partners to reverse "disturbing trends in the nation's obesity epidemic."

The Dietary Guidelines for Americans has been revised every five years since 1980, but never as openly or comprehensively as the revision due out next year, which is currently up for public comment. A final version will be released in January.

As a blue-ribbon panel pored over often-conflicting scientific research, outside groups urged their versions.

In the past, the panels summoned by the US Departments of Agriculture and Health and Human Services to update the guidelines settled for minor tweaks: The "avoid too much sugar" guideline in 1980 and 85 evolved into "use sugars in only in moderation" in 1990, then "choose a diet moderate in sugars."

In the 2005 revision, sugar is dropped from the list of foods to avoid. So are some fats. Instead, Americans are urged to choose fats and carbohydrates "wisely for good health." The most conspicuous loser is salt, which has taken a heavier hit in every revision cycle. The 2005 draft urges Americans to "choose and prepare foods with little salt," down from "less salt" in the 2000 version and "use salt and sodium only in moderation" in 1995.

The main theme in the new revision is eating a variety of foods, "while staying within energy needs." In addition, the guidelines caution that factors such as large portion sizes in restaurants, lack of information about calorie content at points of purchase, the cost and availability of fruits and vegetables, and opportunities for safe physical activity also weigh down efforts to maintain "appropriate energy balance." The advisory panel recommends 60 to 90 minutes of moderate to vigorous activity daily for those seeking to control their weight.

"There was a lot of pressure [to stigmatize sugar] because of the obesity crisis, but what they're trying to do is make the emphasis on energy balance: If you consume more energy than you burn, you're going to gain weight, regardless of the source," says Cheryl Digges, public policy director for the Sugar Association.

It's probably one of the most controversial pieces of the new revision.

Students studying nutrition at Tuloso-Midway High School in Corpus Christi, Texas, aren't convinced the new guidelines go far enough. They sent in written comments to the panel urging a revision to "separate healthy, high-fiber, whole-wheat cereals from sugary cereals in layman's terms."

"Cereals in the bread and cereal group is a source of confusion to many," wrote Jennifer Coronado in a comment posted on the US Department of Agriculture website. "The sugary ones are advertising themselves as nutritious only when one adds milk." And she suggests moving the the fine print to the front of the box.

The number of Americans deemed obese is up more than 54 percent since the 1995 guidelines were issued.

Spokesmen for the food and beverage industry say that companies are scrambling to meet some of the new recommendations.

Critics say Congress needs to take a closer look at it's own role in the nation's obesity crisis. "Congress encourages massive overproduction of food," including some $72 billion a year in agricultural subsidies and programs to increase consumption of products such as milk, meat, and corn," says Morgan Downey, executive director of the American Obesity Association. In addition, transportation policies encourage the private automobile, instead of more vigorous alternatives.